Decod 2026

1. Click ‘Get Form’ to open the decod application in the editor.
2. Begin with the Registration Form. Ensure that your phone number and street address are accurate for effective communication.
3. Proceed to the Health Questionnaire. Answer all questions truthfully, consulting family members or medical personnel if necessary.
4. Complete the History and Physical Examination (H&P) section, as it is essential for approval.
5. In the Consent for Routine Dental Treatment section, print your name clearly and provide your signature.
6. Read through the Care Agreement carefully before signing, as it involves care from students and faculty.
7. Acknowledge the Notice of Privacy Practices by signing where indicated, understanding how your information will be used.
8. Fill out the Financial Agreement/Authorization, noting any limitations regarding coverage under Medicaid.
9. Ensure all forms are completed and signed before returning them in the prepaid envelope provided.

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